Individual
LEONA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNMW
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000066645
TN
367A00000X
Advanced Practice Midwife
Primary
APN0000005955
TN
Other
Enumeration date
11/28/2006
Last updated
06/06/2008
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